Procedure Name



BLOOD COMPONENT COMPATIBILITY REQUIREMENTS

PURPOSE

To select blood components immunologically compatible with individual recipients.

POLICIES FOR ROUTINE SELECTION OF RED CELLS, WHOLE BLOOD AND GRANULOCYTES

1. Routine pretransfusion testing for RBC containing components includes:

A. ABO and RHo(D) typing, including a test for weak D phenotypes (Du), performed at least twice,

B. Antibody detection test (antibody screen) using a two-cell panel (no autocontrol),and monospecific anti-human-IgG serum.

C. If the antibody screen is negative and ABO discrepancy is absent, major crossmatch between recipient and donor at immediate spin only using 2 drops of patient serum in tubes,

If the antibody screen is positive or if there is a history of a clinically significant blood group antibody, major crossmatch with 4 drops patient serum, and monospecific anti-human IgG serum after resolution of the serologic problem.

NOTE: Patients with a history of a warm autoantibody and NO clinically significant alloantibody whose antibody screen is currently negative don't require AHG crossmatches.

NOTE: Rouleaux is resolved by the saline displacement technique, and an AHG crossmatch is NOT required.

2. When serologic problems are encountered, steps to resolve them should be initiated. If transfusion is urgent, a supervisor or blood bank physician should be consulted.

3. ABO specific blood components are issued whenever available with the exception of perinatal transfusions. The policies below govern acceptable alternatives when such components are not available or when the patient has requested directed donations.

4. Rh-negative patients must receive Rh-negative blood components whenever available. Rh-positive patients may receive Rh-positive or negative units. (These two statements define "Rh-specific" as used below). Individuals with weak D phenotypes (Du) are considered Rh-positive. When Rh-positive RBCs or whole blood must be issued to Rh-negative recipients consult a supervisor and/or a blood bank physician. (NOTE: HANDLE EMERGENCIES FIRST. Then notify the physician/supervisor.) These individuals may require that the physician sign an Emergency Blood Request form; also, use of RhIG may be indicated.

5. Whole Blood must be ABO-specific.

6. RBC-containing components must be ABO-compatible with the recipient's serum and Rh-specific (see #4 above). When ABO-specific RBCs are not available or are available in insufficient quantities select the next best choice according to the following chart:

| |Alternate ABO |Alternate Rh |

|Recipient's | | |

|Group | | |

| |1st Choice |2nd Choice |Men, Women > 50 |Women ................
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